Dosage & Route

Parenteral

Moderate to severe pain

Adult: 1-4 mg via IM injection or 0.5-2 mg IV injection every 3-4 hr.

Anesthesia

Adult: As premedicant before surgery: 2 mg given via IM injection 60-90 minutes before surgery. As supplement in balanced anesthesia: Doses are given via IV admin; 2 mg shortly before induction and/or an incremental dose of 0.5-1 mg (up to 0.06 mg/kg) during anesthesia. Total dose may vary but usually ranges from 4-12.5 mg.

Nasal

Moderate to severe pain

Adult: Initially, 1 mg, repeated after 60-90 minutes if necessary; may be repeated after 3-4 hr when necessary. For severe pain, initial dose can be 2 mg, repeated only after 3-4 hr.

Therapeutic actions

Butorphanol is a phenanthrene derivative with opioid agonist and antagonist properties. It has central analgesic actions and produces generalized CNS depression. It also alters perception of and response to pain by binding to opiate receptors in the CNS.